{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:31:59Z","timestamp":1770741119114,"version":"3.49.0"},"reference-count":31,"publisher":"Walter de Gruyter GmbH","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,10,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2017-0394_s_999_w2aab3b7c70b1b6b1aab1c16b1Aa\">\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>To evaluate whether intraoperative ultrasound-guided detection and resection of the uterine scar during repeat\/second cesarean can reduce the number of scars and improve uterine scar architecture.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2017-0394_s_998_w2aab3b7c70b1b6b1aab1c16b2Aa\">\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>A prospective controlled clinical intervention trial was performed with the following groups: control group 1 (<jats:italic>CS1-G<\/jats:italic>): first cesarean; control group 2 (<jats:italic>CS2-G<\/jats:italic>): second cesarean utilizing the usual procedure and intervention group (<jats:italic>Int-G<\/jats:italic>): repeat\/second cesarean with intervention. Transvaginal ultrasound scans were performed 6\u20139 months after each cesarean. Both primary (double scarring rate) and secondary outcomes [deficiency ratio=d\/(b+d)] were analyzed. The deficiency ratio describes the thinning of the remaining myometrium (d=residual myometrial thickness) over the \u201capparent\u201d defect (b=scar depth).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2017-0394_s_997_w2aab3b7c70b1b6b1aab1c16b3Aa\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 124 of the 156 recruited women were examined, eight were excluded from analysis. The double scarring rate decreased from 42.9% (12\/28) in <jats:italic>CS2-G<\/jats:italic> to 7.1% (2\/28) in the <jats:italic>Int-G<\/jats:italic> [difference: 35.8%; 95% confidence interval (CI) (13.2, 54.5); P=0.002]. Two-way analysis of variance (ANOVA) revealed a significant difference between <jats:italic>CS2-G<\/jats:italic> and the <jats:italic>Int-G<\/jats:italic> in the deficiency ratio adjusted for elective\/primary cesareans, with thicker remaining myometrium over the scar defect in the <jats:italic>Int-G<\/jats:italic> [difference: \u22120.24; 95% CI (\u22120.34, \u22120.15); P&lt;0.001].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2017-0394_s_996_w2aab3b7c70b1b6b1aab1c16b4Aa\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Ultrasound-guided resection of the uterine scar area during repeat cesareans reduces the scarring rate and improves thickness of the remaining myometrium as detected by ultrasonography 6\u20139 months postoperatively.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2017-0394","type":"journal-article","created":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T07:54:05Z","timestamp":1523519645000},"page":"857-866","source":"Crossref","is-referenced-by-count":6,"title":["Does ultrasound-guided intervention during repeat cesarean sections improve uterine scar architecture and reduce the number of scars? A prospective controlled clinical intervention trial"],"prefix":"10.1515","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6201-9303","authenticated-orcid":false,"given":"Gregor","family":"Seliger","sequence":"first","affiliation":[{"name":"Maternity Clinic\/Perinatal Treatment Center, Center of Fetal Surgery , University Hospital Halle, Martin Luther University Halle-Wittenberg\/Faculty of Medicine , Halle (Saale), ST , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Muendane","sequence":"additional","affiliation":[{"name":"Maternity Clinic\/Perinatal Treatment Center, Center of Fetal Surgery , University Hospital Halle, Martin Luther University Halle-Wittenberg\/Faculty of Medicine , Halle (Saale), ST , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Chaoui","sequence":"additional","affiliation":[{"name":"Maternity Clinic\/Perinatal Treatment Center, Center of Fetal Surgery , University Hospital Halle, Martin Luther University Halle-Wittenberg\/Faculty of Medicine , Halle (Saale), ST , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grit Gesine Ruth","family":"Hiller","sequence":"additional","affiliation":[{"name":"Institute for Pathology , University Hospital Halle, Martin Luther University Halle-Wittenberg\/Faculty of Medicine , Halle (Saale), ST , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Lautenschl\u00e4ger","sequence":"additional","affiliation":[{"name":"Institute for Medical Epidemiology, Biometrics and Computer Science , Martin Luther University Halle-Wittenberg\/Faculty of Medicine , Halle (Saale), ST , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serban-Dan","family":"Costa","sequence":"additional","affiliation":[{"name":"Women\u2019s Clinic, University Hospital Magdeburg , Otto von Guericke University Magdeburg\/Faculty of Medicine , Magdeburg, ST , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Tchirikov","sequence":"additional","affiliation":[{"name":"Maternity Clinic\/Perinatal Treatment Center, Center of Fetal Surgery , University Hospital Halle, Martin Luther University Halle-Wittenberg\/Faculty of Medicine , Halle (Saale), ST , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2018,3,23]]},"reference":[{"key":"2021021318311461181_j_jpm-2017-0394_ref_001_w2aab3b7c70b1b6b1ab2b2b1Aa","doi-asserted-by":"crossref","unstructured":"Ye J, Betran AP, Guerrero Vela M, Souza JP, Zhang J. 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